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Brain Therapy

Brain therapies have been used successfully for centuries. Even when technology was not as developed as is available now.

Brain disorders do not always respond satisfactorily to medications and standard psychotherapy techniques. In such unresponsive cases, Brain Stimulation Therapy is a beneficial technique. It involves direct stimulation or inhibition of the brain with electricity. The electricity is supplied to the brain through electrodes. The electrodes deliver electric pulses directly through brain implantation or non-invasively by placing them on the scalp. The electricity can also be generated through magnetic fields.

From the 17th to early 19th century, Transcranial Electrical Stimulation (TES) machines were available to everyone. Many used it to trigger euphoria and even improve mental performance. In 1801, Giovanni Aldini, an Italian physicist, treated a farmer suffering from melancholia using Transcranial Direct-Current Stimulation (tDCS). In the 19th century, Electroconvulsive therapy (ECT) became a widely used technique in mental facilities globally. This broad adoption came after a neurologist, Ugo Cerletti, used ECT to relieve hallucinations and confusion in a schizophrenic subject.

Invasive brain stimulation treatments started towards the end of the 19th century. It began when a French brain surgeon, Alim L. Benabid, found that Deep Brain Stimulation (DBS) could improve Parkinson’s Disease symptoms. An American neuroscientist, Jacob Zabara, later discovered the use of

Vagus Nerve Stimulation (VNS) in the treatment of seizures. Transcranial stimulation re-emerged in 1985 when the first rTMS device was invented by the English physicist Anthony Barker to treat depression.

Around the end of the 20th century, the search for effective treatments with fewer side-effects than medications caused neuroscientists to regain interest in Transcranial Direct-Current Stimulation.

Nowadays, several methods and devices are available for Brain Stimulation Therapy.

Electroconvulsive Therapy: It involves passing an electric current through electrodes placed at specific locations on the head to trigger a seizure. The seizure usually lasts for less than a minute. This method is often used to manage treatment-resistant depression, bipolar disorders, schizophrenia, catatonia, and high suicide risk cases. It is best reserved for cases that do not improve with other treatments or where rapid response is required (such as catatonia). ECT works quicker than medications, especially in older patients.

Vagus Nerve Stimulation involves sending electric impulses to the left vagus nerve through an implant placed under the skin. It can be used in the treatment of epilepsy and to improve the patient’s mood. It is not to be used as first-line therapy.

Repetitive Transcranial Magnetic Stimulation (rTMS) uses a magnet to stimulate the brain. With rTMS, it is possible to stimulate specific parts of the brain, unlike ECT that produces generalized brain stimulation. This targeted stimulation reduces the risk of side effects. rTMS can be used in treating major depression when medications are insufficient or fail.

Magnetic Seizure Therapy (MST). The device combines certain aspects of ECT and rTMS. It uses magnetic pulses like rTMS and induces a seizure like ECT. The goal of MST is to reduce cognitive side effects while maintaining the effectiveness of ECT.

Deep Brain Stimulation (DBS) involves using a pair of implants that deliver continuous stimulation at a personalized frequency. It is useful in the treatment of Parkinson’s disease (to reduce the symptoms) and OCD. However, it is only used in depression on an experimental basis. DBS is invasive and comes with similar risks as other forms of neurosurgery. Hence, it is only an option when all other options fail.

Choosing the right treatment plan should be personalized.

Brain Therapy requires specific expertise in managing brain disorders and using appropriate devices. Hence, it should only be prescribed and monitored by trained health care professionals. Some of the available Brain Therapy Training includes:

TMS Training focuses on guidelines and the latest developments in TMS and hands-on practice in device set-up and threshold determination.

tCDS Training focuses on the latest developments in transcranial Direct Current Stimulation and the application in various clinical settings

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